I. Field of the Disclosure
The present invention relates to a patient mountable robot that will help a physician to reach a point of interest in a patient's body, and in particular, during an MRI or CT guided intervention in which the patient is inside a bore of a scanner. In such a configuration it is difficult to reach, for example, the patient's joints for arthrography or other similar procedure. Thus, the patient mountable robot is intended to reduce trial and error, increase precision for a needle placement, and be low cost compared to conventional large and bulky robots.
II. Description of the Related Art
The “background” description provided herein is for the purpose of generally presenting the context of the disclosure. Work of the presently named inventors, to the extent it is described in this background section, as well as aspects of the description which may not otherwise qualify as prior art at the time of filing, are neither expressly or impliedly admitted as prior art against the present invention.
Hypertrophic Arthrography is the evaluation of joint condition using imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). The average American child between the ages of 5-14 will experience one sports-related injury during that time period. A significant portion of these injuries involve internal derangements of shoulders, hips, wrists, and other joints. Magnetic resonance (MR) arthrography is the modality of choice for evaluation of suspected derangement of articular labral structures, untreated congenital joint dysplasias, articular cartilage, and other internal structures of the joint since it has higher soft tissue contrast in comparison to other modalities. Currently, arthrography requires two separate stages, an intra-articular contrast injection guided by fluoroscopy or ultrasound followed by an MRI. The inability to leverage the imaging capabilities of the MRI itself and the manual nature of needle placement lead to increased cost, anxiety, and in some cases prolonged sedation time, especially for the youngest and most anxious patients. Moreover, while the MRI could also be used for guiding the needle placement, patient access in the MRI can be difficult, especially for closed bored scanners. Therefore, the development of a small, body mounted robot to assist in needle placement in the MRI environment could streamline the procedure.
The conventional two-step workflow can result in anxiety for the patient, prolonged sedation time when sedation is needed for younger patients, radiation exposure from the fluoroscopic imaging, and may increase cost due to the use of both the fluoroscopy and MRI suite. In typical manual interventions, the physician guides the needle using cross-sectional images to reach a desired position in a joint space or near a bone. Traditional needle manipulation often requires multiple passes to reach the target. In MRI guided interventions, patient access can be difficult, especially for closed bored scanners. Therefore, the procedure is performed in two steps; first the fluoroscopy-guided needle placement and infusion injection is done. In the next step, the patient should be moved to the MRI-imaging procedure immediately to make sure that the targeting point and infusion is correct and effective. Consequently, a need exists for a patient mountable robot that will help the physician do the entire procedure under an MRI or other scanner in a single operation. In particular, there is a need for a patient mountable robot that will also provide a stable guide for the needle and reduce the number of needle passes by providing a steady and precise needle holder, which will reduce the procedure time and avoid exposure to radiation by eliminating the fluoroscopy-guided needle placement, which will reduce trauma to patient and reduce the burden to the physician.
The high-strength magnetic field currently present in a clinical MRI environment makes developing MRI-compatible equipment a challenge. Nonmagnetic materials, MRI-compatible actuators (piezo motors, pneumatic and hydraulic actuators), optical encoders, and sensors are key elements of these robotic systems. A few research groups have reported related work in the field of patient mounted robots for percutaneous interventions. However, none of the conventional patient-mounted robots for percutaneous interventions address the above-noted shortcomings.